Question: Are serial determinations of coagulation ability necessary following a bite of the copperhead snake (Agkistrodon contortrix)?
Answer: Despite the fact that many written guidelines recommend routine and serial determinations of clotting parameters following copperhead snake bite, one recent study reported “Results for INR, PTT, platelet count and fibrinogen concentration remained within normal limits for 79%, 93%, 95%, and 91% of patients respectively.” These authors reported no patients developing bleeding complications following copperhead and presumed copperhead bites. These authors concluded that “In identified copperhead snakebites, it may be safe to forgo serial coagulation testing in both adult and pediatric patients in the absence of clinical evidence of bleeding. (Ali A,et. al. Lack of coagulopathy after copperhead snakebites. 2015 Ann Emerg Med 65:404-409)